Do you walk a migraine treatment tightrope? You need pain relievers to be able to function when a migraine attack strikes. But if you take certain medications too often or in too-high doses, you may get hit with a rebound headache.
It’s a terrible conundrum: Headache pain medication can itself cause headaches. The long-term use of certain pain relievers — prescription or over the counter — can trigger medication overuse headaches in people who have a headache disorder, like migraine. These headaches often occur daily, getting better when you take pain relief medication and then returning as it wears off.
The name medication overuse headache may suggest that the person with migraine is to blame for taking too much medication, the Coalition for Headache and Migraine Patients (CHAMP) points out. (CHAMP prefers calling it “medication adaptation headache” or “medication response headache.”) If you suffer from rebound headaches, it’s important to know that it’s not your fault! It is possible, however, to change your migraine treatment routine to avoid them.
What Causes Medication Overuse Headache?
According to the ICHD-3 diagnostic criteria, medication overuse headache is defined as a headache occurring on 15 or more days per month in a patient with a preexisting headache disorder who has been overusing one or more acute treatment drugs for symptomatic treatment of headache for three or more months. Also, the patient’s headaches cannot be accounted for by another diagnosis.
Not all pain relievers carry the same risk of contributing to rebound headaches:
Higher risk of causing rebound headaches:
- Aspirin
- Acetaminophen
- Combination pain relievers that include caffeine, aspirin and/or acetaminophen
- Prescription medications that include butalbital
- Some acute migraine medications, including triptans and certain ergots
- Opiate painkillers
Lower risk of causing rebound headaches:
- Ibuprofen
- Naproxen sodium
Ways to Prevent Rebound Headaches That Really Work
If you’re experiencing medication overuse headaches, you should talk to your healthcare provider about how to adjust your approach to pain relief. Withdrawing suddenly from pain relievers can be difficult and even dangerous; for instance, seizures can result if you abruptly discontinue a medication containing butalbital.
Your healthcare provider may advise you to cut back on your usage of pain relievers to a level that’s less likely to trigger rebound headaches, or cease using certain pain relievers entirely. But then, you’re faced with a crucial question: How can you manage migraine pain without the medication you rely on?
- Try non-drug treatments for migraine pain relief. Not all treatments are equally effective; some people with migraine report seeing an improvement from biofeedback or acupuncture, but others don’t. CEFALY DUAL, a safe and non-invasive migraine treatment, is clinically proven to provide acute migraine pain relief. In a double-blind, randomized, sham-controlled study conducted across multiple headache centers in the U.S., 79% of acute migraine patients saw pain relief following a 60-minute ACUTE treatment session with CEFALY, and 32% saw pain freedom.
Learn more about how CEFALY DUAL works
- Focus on wellness. When you’re busy and feeling overwhelmed, it’s easy to slip into habits that aren’t so good for you — or your migraine. Practice good headache hygiene by staying hydrated, keeping to a strict sleep and meals schedule, and exercising.
- Manage your stress. Stress is a known migraine trigger — not just the extreme pressure of major deadlines or conflicts, but the everyday strain of managing work, life, health and family. Practice proven relaxation techniques to lighten your stress burden and reduce the likelihood of an attack.
- Cut back on caffeine. Whether consumed in a beverage or ingested as part of medication, caffeine can contribute to rebound headaches.
- Practice prevention. With compliant daily use, CEFALY DUAL’s PREVENT treatment setting desensitizes the Trigeminal nerve over time to reduce the frequency and severity of migraine attacks, thus possibly reducing the need for pain-relieving medication.
CEFALY DUAL is now available without a prescription in the U.S. for the acute and preventative treatment of migraine headaches in adults 18 years and older. Try CEFALY risk-free for 90 days!
**The information in this article is not intended to be a substitute for professional medical advice.
Reviewed by: Deena E. Kuruvilla, MD, a board-certified neurologist and the director of the Westport Headache Institute, where she employs a holistic biopsychosocial approach to diagnosis and treatment. She held clinical appointments at the Yale University School of Medicine prior to starting her own practice and has authored many articles, book chapters, and research publications.
